Reorientation of medical care welfare: a step forward or two back?

• Autor(a) principal: Teixeira, Sonia Maria Fleury
• Data de Publicação: 1985
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista de Administração Pública
• Texto Completo: https://periodicos.fgv.br/rap/article/view/10372

The article intends to bring a contribution to the understanding of changes now occurring in the organization of medical care within the sphere of social security and welfare, from 1981 onwards, when the Conselho Consultivo da Administração de Saúde Previdenciária (Conasp) was instituted. In order to analyse the current process, the writer looks for the roots of the system's present crisis as from the establishment of the Instituto Nacional de Previdência Social (INPS), in 1966, when the organizational model of health services now in force was first implanted. This model has as its characteristics a very ample coverage, the privileged nature of medical treatment, the practice of medicine as an entrepreneurial activity and the differentiation of medical attendance in terms of clientele. The study reaches the conclusion that by the end of the '70s the welfare medicine was already in crisis, due to its impossibility of responding to the growing demand once unaltered the above mentioned conditions, which brought about ever increasing and uncontrollable costs of the health activities. To such a crisis was added the financial crisis of the whole social security system, propitiating conditions which led to the corrective measures proposed in the Conasp plan, among them being outstanding the new system of hospital accounts and the program of integrated health activities. In her analysis of the results of the two latter lines of priority, the authoress ends by questioning their out come because, contrary to representing an effective alteration in the previous model, they may well become the condition for its survival for some more time to come.